Medscape InDiscussion: Myasthenia Gravis

Drs Nicholas Silvestri and Michael Hehir discuss best practices for primary care physicians who see patients with myasthenia gravis. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/990463). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources New and Emerging Treatments for Myasthenia Gravis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407383/ Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527029/ Myasthenia Gravis With Elderly Onset at Advanced Age https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6991148/ Myasthenia Gravis, Respiratory Function, and Respiratory Tract Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132430/ Myasthenic Crisis https://pubmed.ncbi.nlm.nih.gov/37114503/ Telemedicine Visits in Myasthenia Gravis: Expert Guidance and the Myasthenia Gravis Core Exam (MG-CE) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057373/ MGFA Partners in MG Care Program https://myasthenia.org/Professionals/MGFA-Partners-in-MG-Care MGFA List of Cautionary Drugs https://myasthenia.org/Portals/0/Cautionary%20Drugs.pdf

Drs Nicholas Silvestri and Kelly Gwathmey discuss how exercise and other modifiable lifestyle factors can influence how patients experience the burden of myasthenia gravis. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/990462). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Evidence-based Practice in Rehabilitation of Myasthenia Gravis. A Systematic Review of the Literature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739309/ Drugs That Induce or Cause Deterioration of Myasthenia Gravis: An Update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038781/ The Humanistic Burden of Myasthenia Gravis: A Systematic Literature Review https://pubmed.ncbi.nlm.nih.gov/35486970/ Outcome Measures in Clinical Trials of Patients With Myasthenia Gravis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793650/

Drs Nicholas Silvestri and Gil Wolfe get right to the point about when and why thymectomy may be considered as an evidence-based option for treatment of myasthenia gravis. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/990461). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Long-term Effect of Thymectomy Plus Prednisone Versus Prednisone Alone in Patients With Non-thymomatous Myasthenia Gravis: 2-year Extension of the MGTX Randomised Trial https://pubmed.ncbi.nlm.nih.gov/30692052/ Randomized Trial of Thymectomy in Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/27509100/ The Short and Long-term Effects of Open vs Minimally Invasive Thymectomy in Myasthenia Gravis Patients: A Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/36539629/ Prognostic Factors for Conversion to Generalization in Ocular Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/34106649/ Development of a Model Care Pathway for Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/34770107/ Drugs That Induce or Cause Deterioration of Myasthenia Gravis: An Update https://pubmed.ncbi.nlm.nih.gov/33917535/

Drs Nicholas Silvestri and James "Chip" Howard discuss newer and novel myasthenia gravis tools to personalize treatment, including complement inhibitors, FcRn antagonists, biomarkers, and more. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/990460). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Safety and Efficacy of Eculizumab in Refractory Generalized Myasthenia Gravis (REGAIN Study) https://clinicaltrials.gov/ct2/show/NCT01997229 Safety and Efficacy of Eculizumab in Anti-acetylcholine Receptor Antibody-positive Refractory Generalised Myasthenia Gravis (REGAIN): A Phase 3, Randomised, Double-blind, Placebo-controlled, Multicentre Study https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(17)30369-1/fulltext ULTOMIRIS® (Ravulizumab-cwvz) Approved in the US for Adults With Generalized Myasthenia Gravis https://www.astrazeneca-us.com/media/press-releases/2022/ultomiris-approved-in-the-us-for-adults-with-generalized-myasthenia-gravis.html UCB Announces US FDA Acceptance of New Drug Application and EMA MAA Validation for Zilucoplan for the Treatment of Generalized Myasthenia Gravis in Adult Patients https://www.prnewswire.com/news-releases/ucb-announces-us-fda-acceptance-of-new-drug-application-and-ema-maa-validation-for-zilucoplan-for-the-treatment-of-generalized-myasthenia-gravis-in-adult-patients-301676223.html Zilucoplan: An Investigational Complement C5 Inhibitor for the Treatment of Acetylcholine Receptor Autoantibody–positive Generalized Myasthenia Gravis https://www.tandfonline.com/doi/full/10.1080/13543784.2021.1897567

Drs Nicholas Silvestri and Neelam Goyal lay out pathways for successful routine treatment of myasthenia gravis. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/990458). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Adverse Side Effects Associated With Corticosteroid Therapy: A Study in 39 Patients With Generalized Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/34707081/ The History of Acetylcholinesterase Inhibitors in the Treatment of Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/32918950/ FcRn Inhibitors: A Novel Option for the Treatment of Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/36751773/ Ravulizumab: A Review in Generalised Myasthenia Gravis https://pubmed.ncbi.nlm.nih.gov/37166620/ Safety and Efficacy of Eculizumab in Anti-acetylcholine Receptor Antibody-positive Refractory Generalised Myasthenia Gravis (REGAIN): A Phase 3, Randomised, Double-blind, Placebo-controlled, Multicentre Study https://pubmed.ncbi.nlm.nih.gov/29066163/

Drs Nicholas Silvestri and Carolina Barnett-Tapia discuss what you need to know about immunopathogenesis and diagnosis for this relatively rare condition. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989800). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196750/ Complement Inhibitor Therapy for Myasthenia Gravis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283905/ Spotlight on MuSK Positive Myasthenia Gravis: Clinical Characteristics, Treatment and Outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8895578/ A Radioimmunoassay for the Quantitative Evaluation of Anti-human Acetylcholine Receptor Antibodies in Myasthenia Gravis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1541026/